Institutional conditions for the implementation of food, nutrition, and healthcare actions for people with obesity in the state of Rio de Janeiro

Abstract

Introduction: In light of the increasing prevalence of obesity, the organization of healthcare systems, particularly primary care, demands more effective care and health promotion strategies, as well as stronger institutional capacity and management support for the implementation of public policies at the municipal level. Objective: Accordingly, this study aims to analyze the institutional conditions for implementing food and nutrition programs targeting overweight individuals in municipalities in the state of Rio de Janeiro. Methodology: The research was conducted between 2019 and 2021, employing a mixed-methods approach that integrated quantitative and qualitative data collection instruments. Results: The findings revealed significant variations in institutional and management conditions across the municipalities studied. Municipalities with higher Municipal Human Development Index (MHDI) scores demonstrated more favorable conditions for implementing food and nutrition actions. Key challenges identified include the low level of institutionalization of food and nutrition policies, high staff turnover, excessive workloads, insufficient staffing, precarious employment conditions, low wages, and the complexity of providing care for individuals with obesity. Conclusion: This scenario hinders the comprehensive implementation of the National Food and Nutrition Policy at the municipal level and may negatively affect processes essential to the implementation of the Overweight and Obesity Care Line.